Rehabilitation in the community: people with forensic histories

Through our Forensic model of support, Dimensions supports people with very diverse histories to recover, from those who might be considered unlucky to have a forensic label attached to them, to  sexual offenders like Peter (not his real name or photo.) Supporting them to lead fulfilling, safe lives in the community.

Peter has a mild learning disability (FSIQ71) and was detained under Section 37/41 following an index offence of rape and sexual assault against a child.

The victim was his brother and the offence took place over a number of years.

There were also allegations of sexually abusive behaviour towards other relatives.

How can people rehabilitate?

The concept of rehabilitation has been established for people with long-term mental health issues for a number of years. The key themes are:

1. Agency – gaining a sense of control over one’s life and one’s illness. Finding personal meaning – an identity which incorporates disability, but retains a positive sense of self.

2. Opportunity – building a life beyond disability. Using non-mental health agencies, informal supports and natural social networks to achieve integration and social inclusion.

3. Hope – believing that one can still pursue one’s own hopes and dreams, even with the continuing presence of disability. Not settling for less, i.e. the reduced expectations of others.

Precursors to offending

Both research and experience show that there are a set of recurrent life conditions that act as offence precursors and which influence offence motives in people with learning disabilities. Some of these include:

• Unemployment
• Lack of positive relationships
• Social isolation
• Difficulties with structure
• Discrimination and power struggles
• Poor or missed education
• Reduced social and emotional comprehension
• Being bored/unoccupied
• Unrealistic expectations
• Lack of opportunity to address the trauma, trust and learning issues that would be addressed for people who do not have a learning disability and/or autism

In particular, most people with learning disabilities who offend have not had many (if any) positive relational experiences with others including family.

Developing this is one of the best ways to learn and motivate people to live fulfilling and safe lives.

The presence of such conditions is a strong indicator of ongoing risk. As a result, community-based support providers have the responsibility of identifying, discussing and carefully managing these alongside the person in order to prevent relapse.

However, this process is often difficult for people as it is a frightening and daunting prospect for someone who has struggled and who fears failure to be socially included.

Finding reasons to care

Through our relationships, people can be taught the skills that they need to make informed choices about their life within their community, and support them to find ‘reasons to care’.

The good news is that most of the life conditions can be addressed through trained and professional support. In particular, we can teach the skills needed to live safely, focusing on inclusion, relational development, teaching and empathy, social rules and expectations, listening skills and self-discipline.

The focus on relationships where these transferable skills can be taught, support the development of the skills necessary for building successful relationships outside of their paid support system. Supporting people to create a new and positive identity for themselves means that they can become a valued member of their society.

Managing risks

Risk is inherent in these relationships. Risk management initially comes from the support team that is around the person, but responsibility for managing risk can transfer to the individual as he or she acquires the skills and tools to manage these themselves.

Once someone understands his or her triggers, has a real reason to care, and has the tools to manage their own behaviour, it becomes possible to start planning reductions in support needs and costs.

Alongside the risk management strategies is the Outcomes and Development Plan, which highlights areas that the person needs to develop in order for the risk to be reduced.

Included in this plan is how the person is going to be supported to develop these skills and who is responsible for supporting this development.

This supports the understanding of the difference between delinquency and criminality and how this can impact on a person’s inclusion within their community.

As for Peter, he is now being supported in making decisions that are right for him by the Forensic team. He is engaging in activities that are meaningful for him including football – he’s been made team captain! He also enjoys going on bike rides. He now recognises the need for structure and routine in managing his risks.

Peter has developed good working relationships with the team around him, reducing his social anxiety which was a trigger for his offending behaviour. This has also helped develop community participation which was previously prohibited due to his anxiety and impulsive behaviours.

He is being encouraged to ask questions about appropriate boundaries, and he now has unsupported time in the community once a week and travels using public transport independently to visit his mother every other Sunday.

Peter was initially supported at all times on a 1:1 basis. The level of support he receives when in the community has reduced over time to reflect his progress.